Provider Demographics
NPI:1700416591
Name:LATORRE, ARMANDO DAVID
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:DAVID
Last Name:LATORRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5185
Mailing Address - Street 2:
Mailing Address - City:ARIZONA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85123-2860
Mailing Address - Country:US
Mailing Address - Phone:520-233-1279
Mailing Address - Fax:
Practice Address - Street 1:10559 W FERNANDO DR
Practice Address - Street 2:
Practice Address - City:ARIZONA CITY
Practice Address - State:AZ
Practice Address - Zip Code:85123-8512
Practice Address - Country:US
Practice Address - Phone:520-233-1279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician